Proud Diabetic

One of the most difficult things I find with having type 1 diabetes is unexpected changes in my insulin needs.

I've been dealing with this recently. Just a couple of months ago, my sugars were running high quite frequently, especially in the evenings. My doctor was recommending more and more insulin to compensate at dinner.

Then, suddenly, my insulin needs suddenly reversed course. I started crashing all the time and had to back off my once-a-day Lantus dose by several units.

Now I'm taking one unit less of my daily Lantus than I used to, but I'm no longer having the same problem with the highs. In fact, my sugars have been under great control, so why am I complaining?

The hardest part of this kind of thing is trying to figure out something that often has no rhyme or reason to it. I have a guess at what could have caused part of the change, but not all of it. I went through a 2- or 3-week period where I wasn't riding my horse, and it was shortly after I started riding again that I started crashing all the time. However, this doesn't explain why I'd been struggling with highs for a month or longer, as I was riding regularly during part of that period.

Whether or not you can find an explanation for abrupt changes in your insulin needs, one thing is for sure — having diabetes requires a lot of vigilance.

Labels: treating diabetes

I haven't posted to this blog in quite a while, I guess partially because I have barely had time to check my sugars, let alone think about diabetes for long enough to write a blog post about it. Between the holidays, a sick cat, and a few other contributors, I have been quite busy.

But today I saw a story on NPR that made me want to come over here and blog again: Despite Advances, 'Diabetes Rising'

It's a promotional story for a new book about the increase in diabetes, written by a type 1 diabetic and an investigative journalist. The radio story lasts for about 30 minutes, but I took notes, so I'll highlight what I thought was noteworthy:

A few of Hurley's quotes:

Diabetes is a "disease of modern culture."

"The world we're living in is a diabetes machine," referring to aspects of the American lifestyle, which seem to contribute to a higher incidence of both type 1 and type 2 diabetes: lack of activity and exposure to sunshine, pollutants, etc.

Apparently diabetes (both types) is increasing faster than obesity itself, indicating that obesity isn't necessarily the only cause. According to Hurley, in children born in 2000, a third of the boys and 39 percent of the girls will be diabetic.

He talks about the difference between type 1 and type 2:
- Type 1 is an autoimmune disease that results in a dead pancreas and no insulin production: "There's no diet that will save you."
- Type 2, although it has been seen as a condition that results from age, inactivity, and poor diet, is now being seen in younger people, even children, and in people who are not actually overweight.

A brief mention is given to what Hurley calls "diabulemia," which he says occurs in about a third of young women who are insulin dependent: They actually stop taking their insulin in order to lose weight. Scary!

He is also very clear that there is NO SUCH THING AS PERFECT CONTROL. "We need to accept that we are human beings, and we were not put here to control our blood sugar, and we do the best we can." Doctors need to understand that "we've got more important things to do with our life than stare at our blood sugar all day."

He also talks about the artificial pancreas — basically a combination of insulin pump and continuous glucose monitor — and the frustrations in the medical industry as to why the FDA won't approve such a device. "It's entirely doable, all the products exist, all we need is some final testing and get the FDA to wake up."

Finally, a listener sent in an email about how the medical industry seems to have backed off of the idea of finding a cure, and questions whether that's because they benefit more from treating diabetes than from curing it. While Hurley doesn't think they are intentionally keeping people sick in order to make money off of them, he does say "they want to make money. They need to make money — that's their job. But it's the job of people with diabetes to demand harder work and the kinds of research that will get us to a cure."

Hurley doesn't seem to think that cure is likely to be biological just yet, by the way — he thinks a "computer cure" (i.e., the artificial pancreas) is much more attainable.

Finally, he also commented on how much we as diabetics have to spend on health care — it's "just obscene," he says, stating that he doesn't think it has to cost this much.

***

Although the radio spot talked about diabetes in a more general sense, the book itself sounds like it is tackling the question of why diabetes is becoming so much more common. I've put a hold on it with my library (it's on order), so as soon as I read it I'll be back with a little more on the subject.

Labels: diabetes in the media

With Halloween coming up, USA Today felt it necessary to run this article, about whether or not diabetic kids can celebrate Halloween:

Halloween still a treat for diabetic kids

There are two opposing viewpoints in this article: One set of experts says candy is okay, while the other says no candy, and recommends plotting with the neighbors to give your kid toys instead, or bribing them with iPod downloads to give up their candy.

WTF? When did bribing children become advisable, no matter what they've got?

Okay, let me make this quite clear: Diabetics can have candy. This isn't the 1980s. Our insulins and blood glucose monitoring systems are pretty efficient. There is no need to deprive your kid of candy on Halloween.

I like the first expert's advice:

"Sugar isn't the no-no it once was, but it's still never a good idea to sit down and just gorge on as much candy as you can. We recommend having a plan," says Debby Johnson, a nutrition and wellness coach for diabetes website Fit4D.com.

Johnson recommends getting your child involved in his or her health choices before the chocolate and Gummi worms come home.

"Do some exploring in the grocery store before Halloween. Look at different bags of candy to see how many carbohydrates are in each piece," Johnson says.

Basically, he's saying not to let diabetic kids graze mindlessly (not a good idea for anyone, actually), but to plan out how much candy they're going to have, know what is in each one, and take the correct amount of insulin.

I would also add that your diabetic kids need to be required to test their blood sugar every hour when eating candy, and correct as necessary. I find that candy and some foods, no matter how many carbs they are supposed to have in them, have a more significant impact on my blood sugar than I expect. I think it's because the super-processed sugar hits my bloodstream faster, upping my resistance to the insulin before it can take effect. (The higher your blood sugar levels are, the more resistant you are to insulin.)

They do say to be sure to moderate and not let them eat too much candy at once, but I have to say I don't think it does too much harm if they do. Just require that they keep checking their blood sugar every hour and correct as necessary. Honestly, the sooner the candy is gone, the sooner any spike in blood sugar can be brought back under control!

Labels: diabetes and diet

I haven't blogged on here in a while, but I heard some exciting news this morning that I just had to share: A recent poll found that support for the public option in health care reform is rising.

The article reports that 57 percent of people support there being a public option, up from 52 percent over the summer. And 76 percent of people support the public option if it is state-run and only available to people who can't get affordable private health insurance.

This last part is particularly exciting to me, since after all, that is my biggest reason for supporting the health reform bill and the public option: the belief that someone like me, with a condition that is life-threatening if it is not properly managed, should not have to become ill and possibly die because they can't get or afford health insurance.

I was disappointed to see that Obama's approval ratings have slipped, but perhaps he can recover, just as the popularity of the health reform has!

Labels: politics

This morning an email was waiting for me in my inbox: The American Diabetes Association is sponsoring an online petition, asking for health care reform for diabetics.

The current health care system needs to be changed. Health care reform needs to ensure:
- People are not denied coverage because they have diabetes or required to pay higher premiums because of they have a chronic disease
- Health insurance covers basic diabetes needs
- Access to the tools to prevent diabetes
- An end to the racial and ethnic disparities in how diabetes affects Americans

Please sign this petition and take a stand for better health care for diabetics!

Labels: health care reform

An article ran today about how President Obama is going to require young adults under 30 to buy health insurance. The article talks about how young adults ages 19 to 29 are thought of as "young invincibles," and get away with not buying health insurance because this age group is generally pretty healthy. Of course, that hurts everyone else, because the whole idea of insurance is that the risks and costs of a small minority are borne by the whole population and therefore made more manageable for everyone.

There's only one problem with this.

Young invincibles, my @$$.

I was diagnosed with type 1 diabetes at age 22. I had spent a year or two without health insurance myself, but luckily the year before I'd gone back to school and therefore was covered again under my parents' insurance. I can only imagine how much trouble I'd have been in had I not been covered.

So actually, requiring this age group to buy health insurance will help more than just health care reform. It'll also help those young adults who have type 1 diabetes and other conditions lurking in their bodies, just waiting to make themselves known!

Labels: health insurance

And by "gearing up," I don't mean anything nice.

I wouldn't be surprised if the health insurance companies are a little bit worried about losing money when the reform bill passes. (Notice I said when, not if — I think something will pass, the only question is whether or not it will have a public option.) Something my mom told me about the other day certainly makes me wonder if this kind of thing is a preemptive strike, to lock in certain discriminatory policies before health care reform makes it impossible for them to makes these kinds of changes.

My mom was talking to someone at her work who has type 2 diabetes. Since it's a state job, they don't pay a very large portion of the employee's health insurance policy, so he has Kaiser — a health insurance company in Colorado that has all its own doctors, and is therefore usually cheaper than other insurance companies.

Anyway, they apparently decided they were losing too much money on him, so they cancelled his policy. Yep — just up and cancelled it. This is apparently a growing trend: A recent article talked about the growing number of rescissions, which is where insurance companies drop policyholders because they cost too much. The insurance companies, of course, claim it's because of fraud, but we know better.

In this man's case, however, they cancelled his policy, then told him to reapply. His new policy cost four or five times more than the old one, which seems to be why they cancelled his policy: so that they could raise his rates.

To add insult to injury, it turned out that he also had to make a deposit for the new policy to take effect — and they withdrew the money directly out of his account. This was, of course, hidden in the 30 pages of small print in the contract.

This seems to be the case with other insurance companies, as well. A survey was done that indicates health costs will be rising. It sounds like employers are coping with rising policy costs by passing on some of the price increases to their employees.

If you ask me, I think health insurance companies are concerned about the possibility that a health care reform bill will pass; I'm sure the thought of a public option particularly alarms them. To cope, I think they are raising costs across the board, and doing what they ccan now to dump (or overcharge) policyholders who cost them money. After all, when the legislation does pass, they may not be able to raise costs again (or discriminate against people) so easily, so they are probably trying to lock in as many of these changes as possible now!

Labels: health insurance